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目的本课题观察胰高血糖素样肽-1(GLP-1)受体激动剂对2型糖尿病患者的治疗,通过对转氨酶、糖化血红蛋白、血脂及脂质运载蛋白-2的检测,探讨胰高血糖素样肽-1受体激动剂与血脂代谢间的关系,从而更有利于对2型糖尿病患者慢性并发症的控制。方法给药方法:两组初发2型糖尿病患者均口服二甲双胍1500 mg,根据治疗方式不同随机分成两组:二甲双胍联合GLP-1组(GL)24例,二甲双胍联合生理盐水组(NS)24例,共给药16周。试验中随访体重指数、转氨酶、糖化血红蛋白、血脂及载脂蛋白-2。试验前3周为导入期,均注射生理盐水1 ml,皮下注射;第4~7周GL组给予GLP-1受体激动剂5μg,每日2次;第8~16周给予GLP-1受体激动剂10μg,每日2次。结果 (1)两组体重、体重指数、糖化血红均降低(P<0.05)。(2)GL组甘油三酯、总胆固醇、低密度脂蛋白、载脂蛋白-2明显降低(P<0.05),NS组无明显降低(P>0.05)。(3)GL组转氨酶明显降低(P<0.05)。结论二甲双胍或二甲双胍联合应用GLP-1受体激动剂均可降低初发2型糖尿病患者的体重及糖化血红蛋白。GLP-1可更加显著地降低糖尿病患者甘油三酯、总胆固醇、低密度脂蛋白、脂质运载蛋白-2的水平。
Objective To investigate the therapeutic effect of GLP-1 receptor agonist on patients with type 2 diabetes mellitus (T2DM) through the detection of aminotransferase, glycosylated hemoglobin, lipids and lipocalin-2 The relationship between glucagon-like peptide-1 receptor agonists and lipids metabolism may be more conducive to the control of chronic complications in type 2 diabetic patients. Methods of drug delivery: Two groups of patients with type 2 diabetes were oral metformin 1500 mg, according to the different treatment were randomly divided into two groups: metformin combined with GLP-1 group (GL) 24 cases, metformin combined with NS group (24 cases For a total of 16 weeks. Body mass index, aminotransferase, glycosylated hemoglobin, lipids and apolipoprotein - 2 were followed up in the trial. 3 ml of GLP-1 receptor agonist was given to the GL group twice a day during the first 4 weeks to the 7th week; GLP-1 was administered from the 8th to the 16th week Body agonist 10μg twice daily. Results (1) Body weight, body mass index and glycosylated hemoglobin decreased in both groups (P <0.05). (2) The levels of triglyceride, total cholesterol, low density lipoprotein and apolipoprotein-2 in GL group were significantly lower than those in NS group (P <0.05). (3) The aminotransferase in GL group decreased significantly (P <0.05). Conclusions Metformin or metformin combined with GLP-1 receptor agonist can reduce the body weight and HbA1c in newly diagnosed type 2 diabetic patients. GLP-1 reduced the levels of triglyceride, total cholesterol, low density lipoprotein and lipocalin-2 in diabetic patients more significantly.